“We are not non-medicos in the truest sense, we simply do not possess medical degrees but our degrees namely MSc and PhD is medical in nature and we do possess the knowledge,” claims Dr Ayan Das, General Secretary, National MSc Medical Teachers' Association (NMMTA). “MSc and PhD degree holders have been part of the medical education system of the country for four to five decades and now, our work is being discredited, how is it justifiable?” says Dr Das.
The protests against these “non-medicos” have been ensuing as the Ministry of Health and Family Welfare (MoHFW) revised the existing clause of the TEQ regulations in June 2023 that increased the percentage of faculty intake from 15% to 30% and allowed MSc/PhD graduates to be integrated into the Departments of Anatomy, Physiology, Biochemistry, Pharmacology and Microbiology. The previous mandate exempted these medical professionals from taking up teaching with the Department of Pharmacology and Microbiology.
‘Silent’ discrimination
President of the MSc Medicine Association’s, India (TMMA), Dr Shashank Kambali, says that earlier, their qualification was equal to the qualification of an MD (Doctor of Medicine). “People think we are completely aloof from medicine but we have completed our degrees from medical colleges and our degrees are awarded by the Faculty of Medicine,” says Dr Kambali on how these postgraduates and PhD holders are significantly discriminated against within the medical community, whereas, in reality, they belong to the same circle.
Dr Das who is also an Assistant Professor of Microbiology, says that silent levels of discrimination have always existed where a particular job preference has always been noted towards MBBS degree holders. He further says that there has been discrimination in promotion, pay and in a gew instances, at the time of hiring for teaching positions too. “For us, it has always been more challenging but for doctors, they have the privilege of their degree but we have to keep proving our merit.”
He also adds that the National Medical Commission (NMC) 2020 notification that decreed zero intake of MSc graduates in Pharmacology and Microbiology had already limited their scope and with that, individuals might lose their jobs if the intake is further reduced as they would not be re-recruited easily. He says that their numbers, already relatively small in size, are “further pushed to the corner” as contracts are not being renewed and they are not getting jobs any further.
“After doing so much for the community, for the country after the start of COVID where I had to design labs, start tests, validate several tests, it is not justifiable if my knowledge is discredited on no grounds,” he says. Dr Das’s dilemma is not only limited to this, he adds that his subject is medical microbiology, and he cannot shift to industrial microbiology, dairy microbiology or even just general microbiology.
MSc grads not suited for the curriculum?
The notion of them being graduates with just BSc qualifications is “falsely propagated” claims an appeal submitted by the TMMA. It mentions that they are from various disciplines such as Bachelor of Dental Surgery, Bachelor of Physiotherapy, BSc Life Sciences, BSc Nursing, Bachelor of Pharmacy and so on with medical postgraduation degree in medical specialities graduating from reputed institutions such as the Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Pondicherry, Dr NTR University of Health Sciences, Vijayawada, Manipal Academy, Rajasthan University of Health Sciences, Madras University, SVIMS (Sri Venkateswara Institute of Medical Sciences) Tirupati and so on.
Not only this, many of those who qualified MSc have been positioned as the Head of Departments who have been successful clinicians for more than six decades in institutions such as AIIMS, JIPMER and National Institute of Mental Health and Neurosciences (NIMHANS) to name a few. Hence, stationing the argument that medical sciences are varied and negating these degree-holders by branding them as not knowledgeable enough is less than appropriate.
With the online protests gaining gradual momentum, a few medical students and faculties already think that these science graduates barely fulfil the standards of teaching and are ill-fitted when it comes to it. But is there any credibility to their claims, inquired EdexLive.
Dr Kambali, who is also an Assistant Professor in Medicine (Physiology), asserted that when it comes to the weightage of clinical correlation as emphasised in the CBME (Competency-Based Medical Education) curriculum and the need for knowledge to become a competent clinician, it is certainly extremely helpful to understand what is rudimentary to the subject first, the fundamental aspects of a particular subject and later, taking it up with the other clinical studies that the subject may offer.
He adds, “To come up with different approaches, it is pertinent to understand the physiology in order to understand clinical cases . For example, understanding the bodily immune responses in certain conditions and infections such as Covid is very important to understand in terms of physiology so as to approach it clinically. Diagnosis and treatment of a condition can only be done effectivel, if the doctors are well-versed with the normality rather than the abnormality of a condition first.”
The NMMTA General Secretary, speaking further about the CBME curriculum, says that although the government is trying to emulate foreign standards they are oblivious to the importance of clinical research that leads to a better medical infrastructure and eases identification of multiple variants of the same disease.
He reckons that the faculties in medical schools in various countries with excellent medical infrastructure also comprise not only doctors (MD) but professors (PhD) who are science graduates teaching at different schools of immunology, pharmacology, molecular pharmacology, biochemistry and so on.
Not only that, but 20% of the syllabus has vertical and horizontal integration for any subject, such as microbiology with pharmacology or pathology or medicine and so on. “The clinical exposure to is only 1.77% out of the entire syllabus for the first year. but our numbers have only been stipulated as 30% or less, of the entire strength of the teaching faculty,” stated Dr Das.
He questions if possessing an MBBS degree would mean that they are the only ones perfectly suited to teach the subjects, whereas, the MSc/PhD are not, when they have been specialised in the particular fields for 10+ years. He also adds that it is quite unfair to burden 30% of the faculty with the responsibility of teaching clinical integration when there can be more teachers to bring more diversity into the area.
Qualms and appeals
To build a medical infrastructure and strengthen its foundation, can knowledge be discriminated against on the grounds of merely a degree? With a collective collaboration of both these strata of medical workers, will not the country move up the medical ladder? But the country’s medical students, MBBS and MD, tend to think the contrary. What do MSc/PhD graduates have to say about this?
“Students’ claim that we don't know enough is disheartening as these young minds are being corrupted and deviated because of a few individuals’ personal and political agenda. Pivoting the claim to simply one point, that we are not MBBS graduates, cancels our profession completely,” says Shashank. He also emphasises that they have been in this system for decades and all of a sudden, their qualification is not deemed fit by the NMC for teaching at medical colleges and the decision to reduce their numbers as faculty members seems like a hasty one, and not well thought of.
Dr Das is of the opinion that this is “plain manipulation and misrepresentation of the whole scenario”. He says that the MSc/PhD graduates do not want to forcefully take up others’ jobs, but they would like to be allowed to pursue their careers and work with dignity. “We are asking for equal opportunities to appear for a job interview. We must be considered and if they do find that we don't possess merit, then they can dismiss us. But if we are capable enough and prove our worth, then they must consider us," adds Dr Das.
Harking on a similar thought, Dr Kambali adds that they want respect for their profession, recognition given to their work and registration with National and State medical registers as per the provisions of IMC Act, 1956 and NMC Act, 2019 which gives them rights and equality on par with MD postgraduates.
The NMMTA has already filed a case with the Delhi High Court and has also appealed to the Ministry. The MSc Medical Association President said that the association too has filed grievances and submitted them to the government and there is an ongoing case in the Telangana High Court against the TEQ 2020 regulations.
